Ann Lab Med.  2021 Jul;41(4):419-423. 10.3343/alm.2021.41.4.419.

Concordance of Three Automated Procalcitonin Immunoassays at Medical Decision Points

• Cho HW
• Kim SH
• Cho Y
• Jeong SH
• Lee SG

• KMID: 2512723
• DOI: http://doi.org/10.3343/alm.2021.41.4.419

Abstract

Procalcitonin (PCT) is a useful bacterial infection biomarker with the potential for guiding antibiotic therapy. We evaluated the concordance of three automated PCT immunoassays: Kryptor (BRAHMS GmbH, Hennigsdorf, Germany), Atellica IM 1600 (Siemens Healthcare Diagnostics, Munich, Germany), and Cobas e801 (Roche Diagnostics, Mannheim, Germany). In 119 serum samples with a PCT concentration < 5.00 μg/L, Kryptor (reference assay) was compared with the other two immunoassays by Spearman’s rank correlation, regression analysis, and concordance at two antibiotic stewardship medical decision points: 0.25 and 0.50 μg/L. The Atellica IM 1600 and Cobas e801 results showed high correlations with those of Kryptor, with correlation coefficient (ρ) values of 0.97 and 0.99, respectively. However, negative biases were observed in both immunoassays (slope/y-intercept: 0.75/–0.00 for Atellica IM 1600; 0.88/–0.01 for Cobas e801). Atellica IM 1600 and Cobas e801 demonstrated excellent concordance with Kryptor at both medical decision points, with linearly weighted κ values of 0.90 and 0.92, respectively, despite discrepancies, which were more prominent at the 0.25 μg/L medical decision point. Based on these biases and discrepancies, the alternate use of different PCT immunoassays in repeat examinations is inadvisable. Standardization is required before comparing the results of different PCT immunoassays.

Keyword

Procalcitonin; Standardization; Concordance; Immunoassay; Kryptor; Atellica IM 1600; Cobas e801

Figure

• 

  Fig. 1 Comparative analysis of PCT concentrations measured by Atellica IM 1600, Cobas e801, and Kryptor by Passing–Bablok regression (left) and Bland–Altman plots (right). (A) Atellica IM 1600 vs. Kryptor (n=107). (B) Cobas e801 vs. Kryptor (n=113). (C) Atellica IM 1600 vs. Cobas e801 (n=107). Abbreviations: PCT, procalcitonin; CI, confidence interval.

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